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Inspection on 08/02/06 for Beechfields Nursing Home

Also see our care home review for Beechfields Nursing Home for more information

This inspection was carried out on 8th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The standard of service provided by all staff within the home was very good. Service users were protected by robust financial systems, staff training and health, safety and welfare procedures. The quality assurance system ensured that regular feedback was obtained from service users regarding their satisfaction with the service provided. The provider of the home had recently made an application to the Local Authority to extend the home and this had been approved. The service users and families had been kept informed about the plans and meetings had also taken place to outline the proposals and answer any queries. Service users confirmed that they were very happy living in the home and it was observed throughout the inspection that their rights and choices were upheld and respected. A selection of activities was provided for the benefit of the service users and frequent trips out to a variety of places to meet a range of needs. The environment was homely, bright and comfortable and especially clean.

What has improved since the last inspection?

The two lounges, hall and stairs had recently been redecorated with new carpet throughout and all bedrooms had been repainted.

What the care home could do better:

No requirements or recommendations were raised as a result of this inspection.

CARE HOMES FOR OLDER PEOPLE Beechfields Nursing Home 1 Wissage Road Lichfield Staffordshire WS13 6ES Lead Inspector Lynne Gammon Unannounced Inspection 8th February 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Beechfields Nursing Home DS0000060813.V280949.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Beechfields Nursing Home DS0000060813.V280949.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Beechfields Nursing Home Address 1 Wissage Road Lichfield Staffordshire WS13 6ES Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8423 8804 Tudor Care Plc Ms Linda Wheat Care Home 21 Category(ies) of Physical disability (21), Physical disability over registration, with number 65 years of age (21) of places Beechfields Nursing Home DS0000060813.V280949.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. PD Minimum age 60 yrs on admission Date of last inspection 6th July 2005 Brief Description of the Service: Beechfields Nursing Home is situated one mile from Lichfield Town centre, on a quiet lane in a pleasant suburban area. The home was established in 1992 by the conversion of a detached house with the addition of a purpose built extension. Beechfields comprises of 17 single and two double bedrooms, two separate lounges, one leading to a conservatory and a dining room. Externally there are large, well-stocked gardens which are easily accessible for wheelchair users. Beechfields Nursing Home DS0000060813.V280949.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on 8th February 2006 using the National Minimum Standards for Older People as the basis for the inspection. The total time spent for the inspection, including pre and fieldwork, amounted to eight hours. The inspection included a tour of the home, inspection of records, observation and discussions with service users and staff. Since the last inspection on 6th July 2005, no complaints nor any incidents or reports of abuse of any kind had been received and no requirements or recommendations, against the regulations or the minimum standards, were outstanding from the last inspection report. What the service does well: The standard of service provided by all staff within the home was very good. Service users were protected by robust financial systems, staff training and health, safety and welfare procedures. The quality assurance system ensured that regular feedback was obtained from service users regarding their satisfaction with the service provided. The provider of the home had recently made an application to the Local Authority to extend the home and this had been approved. The service users and families had been kept informed about the plans and meetings had also taken place to outline the proposals and answer any queries. Service users confirmed that they were very happy living in the home and it was observed throughout the inspection that their rights and choices were upheld and respected. A selection of activities was provided for the benefit of the service users and frequent trips out to a variety of places to meet a range of needs. The environment was homely, bright and comfortable and especially clean. Beechfields Nursing Home DS0000060813.V280949.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Beechfields Nursing Home DS0000060813.V280949.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Beechfields Nursing Home DS0000060813.V280949.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 4 Contracts were in place for each service user and they received confirmation that the home could meet their needs prior to moving in. EVIDENCE: The ‘Terms of Accommodation’ was examined and contained details regarding: a trial period, termination, fee structure, services covered by the fees, those items/services not covered by the fees, complaints procedure, assessment, care plans, smoking etc. A standard letter, which was used to inform potential service users that the home could meet their needs, was very clear and self-explanatory. Beechfields Nursing Home DS0000060813.V280949.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 10 and 11 All of the above key standards were examined at the previous inspection on 6th July 2005 and were found to be satisfactory. Service users confirmed that they were cared for respectfully at all times and were confident that at the end of their lives, staff would be continue to treat them and their families with sensitivity and dignity. EVIDENCE: Observation and discussions with service users evidenced that they had positive interactions with staff, were treated respectfully and supported in their requests for privacy. The registered care manager confirmed that the development of a resuscitation policy had been discussed, however, changes in need were updated in the care plans at all times including end of life needs. Beechfields Nursing Home DS0000060813.V280949.R01.S.doc Version 5.1 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 14 All of the key standards were reported upon satisfactorily in the report of the previous inspection of 6th July 2005 and the home continued to provide a range of activities to meet the needs of the service users. The home had a relaxed and welcoming atmosphere where people were encouraged to continue with their individualised lifestyle. EVIDENCE: Discussions with the activities co-ordinator evidenced that the social care needs of service users were understood and met very well. A variety of activities and outings were provided for service users and included: bingo, darts, quizzes, word games, reading the newspapers, trips to: St. Mary’s Centre, a working farm, tea with the Mayor, Wyedale Garden Centre, shopping in Sutton Coldfield, Shugborough, Fradeley Junction canal and teashop, Tamworth; entertainers at the home such as: a bird man, children from a local school, a theatre group putting on a pantomime, library services, religious services etc. One service user received RNIB talking books and the home had ensured that she received a special machine and headphones to access these books. No service users from an ethnic minority group were living in the home at the time of the inspection, however, it was clear that the home would make every effort to meet a variety of cultural needs if required. Beechfields Nursing Home DS0000060813.V280949.R01.S.doc Version 5.1 Page 11 Service users confirmed that they were able to make their own decisions and choices within their everyday lives. They were very complimentary about the service provided and all the staff working within the home. There was positive interaction observed between staff and the service users during the inspection and an easy, relaxed atmosphere existed within the home. Beechfields Nursing Home DS0000060813.V280949.R01.S.doc Version 5.1 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 and 18 A satisfactory complaints procedure was in place and service users felt that they were listened to and action was taken to resolve their issues. Service users were supported and enabled to participate in the electoral process and were protected from abuse by the home’s Adult Protection procedure and training on abuse awareness. EVIDENCE: Both the Commission and the home had not received any formal complaints during the last twelve months. Service users confirmed that they did not have any complaints but if any complaints were raised, the registered manager and staff would make every attempt to resolve them as far as possible. The registered care manager confirmed that service users were able to take part in the electoral process by postal vote if they so wished. If any service user wished to visit an election polling station, this was also supported. There had been no incidents or allegations of abuse received by the home or the Commission for Social Care Inspection. The home had an Adult Protection procedure and all staff were due to undertake abuse awareness training in February/March 2006. Beechfields Nursing Home DS0000060813.V280949.R01.S.doc Version 5.1 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22, 23, 25 and 26 Service users lived in safe, well-maintained surroundings, with a range of specialist equipment provided to support independence. Rooms were suitable to meet needs and the home provided a comfortable, clean and homely environment for the benefit of the service users. EVIDENCE: The home was very well maintained both inside and out. The two lounges, hall and stairs had recently been redecorated with new carpet throughout. All bedrooms had been repainted and were individually personalised, homely and bright and suitable to meet the needs of the service users. All bedrooms had covered radiators, smoke alarms and emergency lighting was in place throughout the home. The corridors were found to be free from obstruction and well lit and the home provided a safe environment for those who lived there. Beechfields Nursing Home DS0000060813.V280949.R01.S.doc Version 5.1 Page 14 Specialist equipment was provided and included two hoists, two stand aids, pressure mattresses and two hospital beds. Adaptations to support independence included grab rails, raised toilet seats, spa type of assisted bath etc, and the home was very clean and hygienic. Beechfields Nursing Home DS0000060813.V280949.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28 and 30 Service users were cared for by qualified staff that were competent and trained to carry out their jobs. EVIDENCE: Discussion with the registered manager confirmed that the home currently had 15 carers in the home with four care staff with NVQ Level 2 and three care staff having achieved NVQ Level 3 in care. Three further members of care staff were in the process of completing NVQ Level 2 and one had almost completed NVQ Level 3 training. In addition to this, three other members of staff were about to commence NVQ Level 2 training this month. Once completed, the home would have well over the required 50 of trained members of staff with NVQ level 2 or above working in the home. The records of the type and frequency of training undertaken by the staff within the home were examined. Training records evidenced the following mandatory training had taken place recently: Manual Handling and Fire Safety Awareness by the fire officer and it was also noted that Health and Safety, more Fire Safety Awareness and Protection of Vulnerable Adults was planned for February/March 2006. Other planned training was: Continence Management by the clinical nurse specialist, Infection Control, Falls and Fracture Prevention with risk assessments, First Aid on March 1st 2006 and Palliative Care training booked for April/May 2006. Beechfields Nursing Home DS0000060813.V280949.R01.S.doc Version 5.1 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 34, 35, 37 and 38 The home was run in the best interests of the service users and their views and opinions were taken into account in the running of the home. Financial procedures were robust to protect service user’s financial interests. Records held were accurate and secure and the health, safety and welfare of service users and staff were upheld and protected. EVIDENCE: A quality assurance questionnaire was issued to service users and relatives twice per annum and feedback used to influence service planning. The provider had gained planning permission to extend the home and was in the process of applying to the Commission to amend the current registration for the home accordingly. A letter had been sent to service users, their families and neighbours around the home about the forthcoming extension and meetings had been arranged to answer any queries or concerns. Beechfields Nursing Home DS0000060813.V280949.R01.S.doc Version 5.1 Page 17 It was also noted that a communication sheet was included in each care plan and any issues raised by the service user were documented and action taken. Financial procedures and processes were examined and records of service user’s personal allowances were examined and found to balance with monies held. Records for the protection of service users, individual records and home records were seen to be secure, up to date and in good order. Policy and procedural documentation was examined and it was noted that these were reviewed regularly. A range of records and documentation evidenced that the health, safety and welfare of service users and staff were protected. Fire safety records showed that the fire alarm system was checked on 31/01/06 and testing took place on the same day, the fire extinguishers were serviced in October 2005 and a fire alarm test took place weekly. Other records included: the Apollo bath and hoist checked on 21/10/05, nurse call system checked and tested 31/01/06 and water tank disinfection 26/01/04. The gas system was checked on 16/05/05 and the passenger lift had a routine service on 10/05/05. Beechfields Nursing Home DS0000060813.V280949.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 X 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 4 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 X X 3 3 X 3 3 STAFFING Standard No Score 27 X 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 3 3 X 3 3 Beechfields Nursing Home DS0000060813.V280949.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Beechfields Nursing Home DS0000060813.V280949.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Beechfields Nursing Home DS0000060813.V280949.R01.S.doc Version 5.1 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!